application letter for medical residency training

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Letters of Intent for Residency Match: Process + How To Guide

Posted in: Residency

Table of Contents

The residency match process can be grueling — between away rotations, the endless ERAS application materials, tough residency interview questions, and thank you letters, medical students like you have already put a tremendous amount of work into making their specialty of choice a dream.

But there is still another hurdle before match day: the letter of intent. Keep reading for an in-depth guide on improving your match chances with an LOI.

Looking to secure a US residency spot? Trying to match into a competitive specialty? Build your ERAS application with 1-on-1 support from an expert Physician Advisor.

What is a letter of intent for residency.

A letter of intent (LOI) for residency is a formal message sent to a residency program that indicates this program is your first choice. An LOI can slightly boost your candidacy and tip the scales in your favor if competitive residencies are making tough choices between you and other candidates. 

Check out this sample letter of intent .

An LOI ethically binds you to accept if this program offers you a spot, although it is not technically a legally binding agreement.

This expression of intent should come after your interview. The letter notifies the program and program directors that you’re excited to match there.

The letter of intent can improve your chances for matching with your preferred program. Residency admissions boards must make tough decisions between competitive candidates, so if you can show your commitment, it might help you edge out the competition.

How Do I Write an LOI?

I work with a lot of students who are applying to medical residencies. When they ask about letters of intent, I typically have a few constant pieces of advice:

• Address the letter to the program coordinator or director.
• Briefly introduce who you are and that this is a letter of intent.
• Get to the point. Why are you an ideal fit for this program and vice-versa?
• Make it specific and personal. Do you have a particular relationship with any faculty, alumni, or the city that this particular program is in? Mention details you noticed before, during, or after your interview.
• Include any recent updates that might not be in your ERAS application .
• Concisely conclude your letter with a summary of the letter and a thank you.

Dr. Edward Chang, Chief Resident of the urology department at the University of Washington, wrote a good guide on writing letters of intent , which I encourage you to read in detail. Although his guide is specifically targeted to med school LOIs, the same principles apply to residency LOIs.

Related: How to Fill out the ERAS Experiences Section

Should You Send Multiple Letters of Intent?

No, you should not send multiple letters of intent. It is in very poor form to send a letter of intent to programs that aren’t your first choice. The world of residencies is small, and program directors may talk among themselves. If they find out that you sent a letter to multiple programs, your chances of matching are nill.

Sending LOIs to more than one program would be disingenuous. However, it is acceptable to send multiple letters of interest to programs at the top of your list. Unlike letters of intent which are sent after interviews, letters of interest are sent soon after ERAS submission to indicate which programs you’d like to interview at.

A lot of programs get these letters of strong interest, and they don’t carry much weight.

Read more: Most Important Factors in the Residency Match

When Should You Send a Letter of Intent to Residency Programs?

Ideally, you should send a letter of intent to your preferred residency program in mid-January or the first week or two of February. This allows time for your letter to be reviewed before the NRMP rank order list (ROL) certification deadline.

Some students send letters closer to match day in mid-to-late March, but the goal of this letter should be to encourage admissions committee members at your preferred residency program to rank you high on their ROL, which is due in early March. That’s why I recommend no later than early February.

Getting ready for your residency interviews? Get 1-on-1 guidance from a physician and admissions expert.

What else can you do besides sending a letter of intent.

Besides sending an LOI, you can put your money where your mouth is and rank your preferred program highest on your ranking list. In reality, you likely placed a program number one on your ranking list then sent an LOI, but I just want to make sure we’re on the same page. 

If there’s a program you absolutely want to match with, ask your med school faculty or physicians with whom you have a relationship to call the residency program director or admissions board to put in a good word. It could be like a bonus letter of recommendation. 

Ideally, you already submitted a killer ERAS application tailored towards your preferred program. For instance, your personal statement is a great place to really hammer home how you want to match with this residency above all others. Answer how you’re a great fit for this program.

Watch this webinar from Dr. David Flick on matching with your ideal residency program for more handy guidance.

Template Letter of Intent for Residency

First, here’s an LOI template that is not filled out. After this, you’ll find the sample LOI that I have filled out. 

We recommend that students do not utilize a singular template for a letter of intent (since many letters of intent would be too similar). However, we’ve provided below a general outline that you can follow:

Dear [Director of the Program] , Thank you so much for the opportunity to interview at your program this past December. I was so thrilled to have this opportunity, meet the faculty and residents and see the program in action. I am writing this letter to express my sincere interest in the program and that I will be ranking it as my top choice residency. [Paragraph about why the program is a good fit from a clinical sense.] [Paragraph about why the program is a good fit from a research sense (if appropriate).] [Paragraph about the people you met as well as why the city is a great choice for you.] For all of these reasons, the program is my absolute top choice for residency. I would be absolutely thrilled to match here! If there is anything more I can provide the committee, please do let me know. Sincerely, Student

Sample Letter of Intent for Residency

Below is a sample LOI so you can get a good idea of what one looks like. You are well aware of this at this point in your career, but I encourage you not to plagiarize (or come anywhere close) if you choose to find inspiration in this sample letter.

Dear Doctor Cornelius Smith, Thank you so much for the opportunity to interview at your program last December. I was so thrilled to have this opportunity, meet the faculty and residents, and see Johns Hopkins in action. I am writing to express my sincere commitment to joining Johns Hopkins as a resident physician, as well as my intent to rank your program as my number one choice for residency. Throughout my medical school education and clinical experiences, I have been drawn to General Preventive Medicine at your program due to the specialty’s unique challenges, opportunities for growth, and potential to make the most meaningful impact on the most patients’ lives. Your program’s reputation for excellence aligns perfectly with the electives I’ve taken, the research projects I’d like to be involved in, and my professional career goals. During my interview day at Johns Hopkins, I was captivated by the cohesive and driven atmosphere among faculty, residents, and staff. Your robust curriculum, diverse patient care, and opportunities for research activity will provide me with the training and resources I need to become a well-rounded and competent preventive physician. Did I mention I love Baltimore? The culture is unmatched, yes. But Johns Hopkins is so perfectly placed for massive impact in underserved populations. I am passionate about being a small part in a larger story of restorative healthcare justice. For all of these reasons, Johns Hopkins is my absolute top choice program for residency. I would be absolutely thrilled to match here! I am always available to provide any additional information or answer any questions you may have. Thank you once again for your time and consideration. Sincerely, John Hopkins, Jr.

A letter of intent (LOI) is an optional part of the residency application process, as well as med school admissions before that. It’s you indicating that you ranked a certain program #1 on your rank list in early February . 

Note that some programs do not accept LOIs, so check the specific program’s terms and guidelines before sending.

Also, LOIs are not required by any residency program. If you can’t decide between 2-3 programs, don’t stress — you don’t have to send an LOI.

That said, I have found a letter of intent can make a small difference in acceptance, which is a huge deal when you’re competing against other highly qualified candidates for a limited number of spots. If you know your number one program, just send an LOI. It can’t hurt.

Get expert 1-on-1 support through every step of the match process. Strengthen your CV, craft your ERAS materials, ace your interviews, and match into your top-choice US residency with the help of a Physician Advisor.

Sahil Mehta MD

Dr. Mehta is the founder of MedSchoolCoach and has guided thousands of successful medical school applicants. He is also a practicing physician in Boston where he specializes in vascular and interventional radiology.

See How We Can Help

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Letter of Intent for Medical Residency

Create a standout medical residency application letter using our template to demonstrate your enthusiasm for a residency position.

Updated August 19, 2024 Written by Yassin Qanbar | Reviewed by Susan Chai, Esq.

A medical residency letter of intent is a short, concise letter written at the end of the Match season to communicate to your top-choice medical residency program that they are your preferred choice and explain why. This letter, addressed to residency program directors, is intended to affirm your desire to join their program if matched.

Applying to residency programs involves a lengthy process that continues even after interviews. Applicants must create an NRMP Rank Order List of preferred programs. While not mandatory, many candidates send a letter of intent to potentially gain an advantage over other applicants.

When to Send

You may send a residency letter of intent only to your top-choice program, clearly stating it as your number one preference. Writing to multiple programs can backfire, as it shows they’re not your first choice and makes their exact ranking unclear, potentially leading program directors to question why they’re not your top pick.

Letter of Intent vs. Letter of Interest

Understanding the match process, the role of a letter of intent in the match process, step-by-step guide to writing a residency letter of intent, medical residency letter of intent sample.

Letter of Interest : Sent at the beginning of the Match season, this letter aims to secure interviews by highlighting your enthusiasm, unique qualities, and relevant experiences.

Letter of Intent : Sent at the end of the Match season to your top-choice program, it explicitly states that they are your number one choice and reiterates your fit and commitment based on interview insights.

Key Differences :

• Purpose : Interest secures interviews; Intent influences ranking.
• Timing : Interest is sent early; Intent is sent late.
• Content : Interest highlights unique attributes; Intent emphasizes commitment and fit.

The primary system facilitating securing a residency position in the United States is the National Resident Matching Program (NRMP) , commonly referred to as “The Match.” Here’s a brief overview to help you understand where a Residency Letter of Intent fits into this process:

1. Application and Interview Phase

• ERAS and CaRMS : US residency applicants  use the Electronic Residency Application Service (ERAS), while Canadian applicants use the Canadian Resident Matching Service (CaRMS).
• Interviews : After submitting applications, programs review them and invite selected candidates for interviews during the fall and winter of their final year in medical school.

2. Rank Order Lists (ROL)

• Applicants’ ROL : After interviews, applicants rank the programs they wish to join in order of preference.
• Programs’ ROL : Similarly, residency programs rank the applicants they wish to accept.

3. The Matching Algorithm

The NRMP uses a matching algorithm that pairs applicants and programs based on:

• Number of Available Positions : The number of slots a program has.
• Programs’ Preferences : How programs rank the applicants.
• Applicant’s Preferences : How applicants rank the programs.

On the Monday of Match Week in March, applicants find out whether they have matched to a residency program, but the exact program remains undisclosed until Friday. For those who do not match initially, the Supplemental Offer and Acceptance Program (SOAP) provides another opportunity to secure a position.

If you’ve reached the interview stage and have identified your top-choice program, a Residency Letter of Intent can be a strategic tool to enhance your chances of matching. Here’s why and how it matters:

• Express Strong Interest: It demonstrates your commitment and genuine interest in the program, signaling to the directors that you are serious about joining their team.
• Competitive Edge: Programs prefer candidates who show a keen interest in them. Sending a letter might increase your chances of being ranked higher on their ROL.
• Mutual Match Assurance: Programs aim to fill their positions with candidates who are likely to join if offered a spot. Your letter reassures them that you are highly likely to accept their offer.

When and How to Send

• Timing: After your interviews and before programs finalize their ROLs.
• Content: Clearly state why the program is your top choice, reflect on your interview experience, and reiterate your fit and enthusiasm for the program.

Your residency letter of intent should be concise, professional, and no longer than one page (200-300 words). Here’s a step-by-step guide to help you create a compelling letter:

Step 1: Introduction

• Introduce yourself.
• Mention the date of your interview.
• State your intention to rank this program as your top choice.

“My name is [Your Name], and I had the pleasure of interviewing with your program on [Interview Date]. I am writing to express my strong interest in ranking [Program Name] as my number one choice in the upcoming Match.”

Step 2: Body Paragraphs

Explain why this program is your first choice.

• Highlight specific aspects of the program that excite you.
• Mention any research opportunities or unique features that appeal to you.
• Refer to your interview experiences that solidified your decision.

“I am particularly drawn to [Program Name] because of its outstanding research opportunities in [specific field]. During my interview, I was impressed by the faculty’s commitment to [specific aspect], which aligns perfectly with my career aspirations. The program’s mission of [program’s mission/values] resonates deeply with my own professional values.”

Show how you are a great fit for the program

• Provide examples from your past that demonstrate alignment with the program’s values.
• Explain how your skills and experiences will contribute to the program.
• Describe how the program will help you achieve your goals.

“Throughout my medical training, I have actively engaged in [specific activities or roles] that reflect the values upheld by [Program Name]. My experience in [specific skill or experience] has prepared me to contribute effectively to your team. I am confident that the resources and mentorship available at [Program Name] will be instrumental in achieving my short-term and long-term goals in [specific career path].”

Include any relevant updates

• Mention new publications, volunteer experiences, or employment that enhance your application.

“I am also pleased to share that my recent research on [topic] has been accepted for publication in [Journal Name]. Additionally, I have continued to volunteer with [Organization], further enriching my experience in [relevant field].”

Step 3: Conclusion

• Summarize your reasons and reiterate your ranking decision.

“In conclusion, I am deeply impressed by the exceptional training and supportive environment at [Program Name]. I am confident that this program is the ideal place for me to grow both professionally and personally. I am enthusiastic about ranking [Program Name] as my top choice and am eager for the opportunity to contribute to and thrive in your esteemed program.”

Download a customizable template available in PDF or MS Word formats.

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Letter of Intent

Residency Letter of Intent

A residency letter of intent is a formal document prepared by a candidate to convince the residency program of their choice to admit them into their training program. It is typically sent after the candidate has completed their residency interviews and wishes to improve their chances of being accepted as a trainee into their first choice institution.

The residency program is a crucial part of the medical profession as it allows you to receive your license and practice in your field of training. Because medical institutions see a lot of candidates every year, you can use this letter of intent to stand out from the crowd.

Why Should You Send a Residency Letter of Intent?

Sending a letter of intent will communicate to a residency program that they are your first choice and that you will rank them as so on your Rank Order List (ROL). Doing so can hold the following benefits:

• It can prompt a re-review of your application
• It can give you an edge in the competition

How to Send Your Letter

Consider the following when sending your letter:

Type: While an email may be faster, especially if you are pressed for time, a physical letter will help you stand out in an increasingly digital age.

Format: Use the block or semi-block format, with a clear subject line such as “Letter of Intent” and address the letter to the Program Director, by name.

Length: A concise letter will convey your interest regarding the residency without overwhelming the director. Try keeping your message to a single-spaced page or less of 200 to 300 words.

What to Include in Your Letter of Intent

An effective Residency Letter of Intent should include the following details:

• Your identity, you can mention your name and when you hand your interview for the program
• A statement expressing your intent to rank the program first on your ROL
• Your reasons for applying for the program and why you believe it is the right fit for you.
• Your qualifications and qualities that make you the right fit for the program.

What Not to Include

The NRMP imposes strict rules on residency applicants and programs. For example, as an applicant, you are prohibited from asking an institution how they plan to rank you. As such, you should avoid including anything in your letter that could be construed as trying to solicit this information. Some of the statements you should avoid include, ‘I look forward to hearing from you’ and ‘I am awaiting your response’

Residency Letter of Intent Format

{Program Director’s Name}

{Institution’s Name}

{Institution’s Address}

{State, City, Zip Code}

Re: Intent to Train at {Institution Name}

Dear {Mr./Mrs./Ms./Dr. Last Name},

I am writing to express my interest to join the {field name} residency program at {institution name}. I had an interview at the institution on {interview date} with {interviewer name}, and I am confident this program is the perfect fit for me.

Your residency program interests me because {explain why it is your top choice}. I studied at {school name}, where I obtained my {qualifications}. I also engaged in {mention extra-curricular activities}, and I believe this makes me a suitable candidate for your program.

Given the opportunity to join you, I will {make professional declaration of your goals}.

Thank you for your time and consideration.

Sample Residency Letter of Intent

7th April 2031

Helena Gilbert, MD

Director, Oncology Residency Training Program

Georgia National Hospital

009 President St.

Atlanta, GA 43109

Re: Intent to Train at GNH

Dear Dr. Gilbert,

I am writing to express my interest to join the Oncology residency program at Georgia National Hospital. I had an interview at the institution on 1 April 2031 with Dr. Garry Hernandez, and I am confident this program is the perfect fit for me.

Your Oncology Program is the most advanced in the country and has been solely responsible for over 30 percent of the advancements in the field. I believe training there will help me reach my best potential.

I studied at Harvard Medical School, where I obtained my M.D. I was also part of the Cancer Treatment Science Program that studied the effectiveness of radiotherapy for brain tumors.

Given the opportunity to join you, I will dedicate my time and energy to my training the advancement of science. Thank you for your time.

Mercy Griffin

Residency Letter of Intent (Word Template)

Final Thoughts

The main purpose of a Residency Letter of Intent is to convince the program director that their residency program is first on your list of programs. It separates you from the pool of other potential trainees by highlighting your eagerness to join the institution of your choice.

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Residency Letters Of Recommendation: The Ultimate Guide (with ERAS Samples)

Table of Contents

Introduction

When I reviewed residency applications as a program director, I was always reassured when I read a letter from someone I knew and trusted.

Therefore, because program directors value the opinion and assessments of people with whom you have worked during medical school, and, especially those letters from people within the specialty to which you are applying, ERAS letters of recommendation become one of the most important parts of your residency application.

Knowing from whom to ask for letters, how to ask for them, when to get them, and how to ask is often a major concern for residency applicants.

Below we have answered your most pressing questions about residency letters of recommendation.

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When should I ask for letters of recommendation?

At any time during your medical education, when you identify someone with whom you have rapport and who thinks highly of you ask that person if she would be willing to write you a strong letter of reference in the future. Then be sure to keep in touch with that individual from time to time. Keep the attending updated on your progress and achievements so when it comes time to write your letter she won’t have to play catch up, which will make the letter more sincere.

Assuming you are applying for residency in September, you should request letters by May or June, if possible. However, since many of your key rotations will likely be in June, July, and possible August of your fourth year of medical school, we advise asking those letter writers as soon as you can so they can submit by September 15th.

How should I ask for letters of recommendation?

How you go about asking someone to write a letter depends in part on your relationship with the individual. If an attending offers to write a letter on your behalf and you have had an open dialogue about his doing so, then simply ask him if he would like any supporting documentation. 

Otherwise, it is best to schedule an appointment to meet with the attending. I suggest first requesting this meeting via email. If the email isn’t answered in three to four business day, follow up with a phone call.

You also want to remind your letter write about deadlines since they may not be aware of them.

We suggest you try and personalize your request as much as possible.

Here is a sample email letter request:

Dear Dr. Murray,

I will be applying for residency in otolaryngology this fall and I am writing to ask if you would be willing to write me a letter of reference. I really enjoyed my rotation with you where I learned so much about the practice of ENT both in the OR and in the outpatient setting. This rotation is what really solidified my desire to practice ENT. Since then, I have written one case report and started a research project with Dr. Katz. As we talked about during the rotation, I hope to return to Texas for residency so I can be closer to family. I would be happy to meet or speak with you, whatever is easiest for you. I have attached my CV to this email for your reference. I will be submitting my ERAS application in September and would great appreciate if you could send the letter by then. 

Thank you for your time and consideration.

Sincerely, Krystal Khan, MS IV

During the meeting, it is fair to ask this person openly if he would be willing to write a strong letter on your behalf. You must hope that you will get an honest reply. If you sense any hesitation, walk away. You don’t want any mediocre or poor letters in your profile.

Your job is to make the letter writer’s job as easy as possible. Arrive at the meeting with a folder in hand that has a copy of your CV, your personal statement (if you have already written it), and any information he may need, such as your AAMC number and where the letters should be sent. 

Some attendings may refer you to their administrative assistants, who will let you know what materials are needed for the attending to compose your letter. Every letter writer has his or her own approach to writing letters and therefore each will make different requests regarding the background information they want from you. 

Who should write my letters of recommendation?

Which letters have the most impact when it comes to residency? It depends. If you are applying for orthopaedic surgery, for example, you don’t want to have three letters from non-orthopaedic faculty. When applying to residency, titles matter; a letter from a community doctor will carry less weight than a letter from the chair at a major academic center.

That said, you want to get letters of reference from people who know you well. You want to have a minimum of two letters from people within the specialty to which you are applying and a maximum of four. For very competitive specialties we suggest having at least three letters from with the specialty.

Should I get a letter from a big name in the specialty?

A letter from someone with a “big name” with whom you have never worked won’t be strong. The best letters come from people who know you well and have worked with you directly.

Should I only get letters from within the specialty I am applying for?

Across all specialties, program directors surveyed indicated that letters of reference in the specialty were one of the most important factors in deciding whom to interview. Ideally, we like to see three to four letters from attendings within your specialty and a minimum of two. If you have done research within your speciality, that also “counts” as a specialty letter. There is no  question that when reviewing applications I paid much more attention to letters from within my specialty.

Most influential are letters from clerkship directors, program or associate program directors and chairs within the specialty to which you are applying. Strong letters from department faculty, while they might have less weighty titles, are still valuable.

What makes for a strong residency letter of reference?

The best letters of reference are from people with whom you have worked directly and who know you well. It also helps if your letter writers like you and want to see you succeed. In other words, the strongest letters come from those who believe in you and can offer the strongest endorsements of your candidacy.

How many letters of recommendation should I have?

ERAS allows you to select four letters to be sent to each program and we recommend having at least two of these letters from attendings within the specialty to which you are applying.  Since ERAS allows you to upload multiple letters of reference which you can then assign to programs, it never hurts to ask for more letters than you need in case someone doesn’t come through. You may also have some letters you only want to send to specific programs.

For example, maybe you did a rotation at Brown and asked for a letter from an attending there. But, you don’t think the letter will be as strong as some of your others. So you don’t offend the Brown attending, select that letter to be sent only to Brown and not other programs where you are applying.

How do I nudge my letter writer?

It can get quite awkward if a letter write is late in sending in a letter. Remember, not all letter writers understand the importance of timeliness in this process. I suggest you gently remind the letter writer if they haven’t submitted their letter by September 1st. Ideally, if you see the letter writer in person, mention it to them. Alternatively, send a polite email like the one below:

Dear Dr. Smith,

I hope you are doing well. I am sure you are very busy, but, I wanted to remind you that ERAS applications start getting submitted to programs on September 15th and the ERAS system indicates they have not yet received your letter. If there is anything I can do to help expedite this process or make it easier for you, please let me know. I appreciate your time and consideration.

Sincerely, Getmein (999-999-9999)

Can I read my letters?

You should always waive your right to read letters of reference. So, no, you cannot read your letters. If your letter writer sends you the letter to read, then he or she wants you to read it and there is nothing illegal about that!

What if I am asked to write my letter?

We find that more and more attendings are asking applicants to compose letters of reference that they then sign. Why? Attendings are busy and this means they have one less thing to do! Take advantage of this opportunity and write a stellar letter!

How do I thank my letter writers?

We suggest thanking your letter writers after the letter is received and again once you match.

What is the deadline to submit ERAS letters of recommendation?

There is no firm “deadline” for letters to be submitted, but, keep in mind that many programs won’t review your application until all of your letters are received. For this reason, we suggest making sure all of your letters are submitted by September 15th.

Should my letter be addressed to someone specific?

Unless a letter writer is composing a letter for one specific program, the letter should not be addressed to an individual or program.

How do I get a Chair letter if the department chair doesn’t know me?

Many programs and medical schools require that one of your letters be from the chair of the department. If this is the case, we can assure you that the chair has a prescribed way of getting the information she needs to write a strong letter of reference. It is likely she will ask for a CV and personal statement and she may ask other department faculty to chime in or may use excerpts from your clinical evaluations. Remember, your chair wants you to match well and will write a letter that will help guarantee that as much as possible.

Where should my letters be sent?

Your medical school Dean’s office may collect your letters for you. Alternatively, you will log in to MyERAS and download a letter request form (LRF) for each letter writer. The form will have instructions for your letter write about how to upload the letter to the Letter of Reference Portal (LoRP).

If I am applying to more than one specialty does my letter writer need to write more than one letter?

Yes. Each letter should be written for the specialty to which you are applying. Therefore, if you are applying for two specialties, you should notify your letter writers about this so they can compose distinct letters for each and label them differently when uploading them to ERAS.

How do I indicate in ERAS where I want my letters sent?

Before you submit your application you will need to assign letters to individual programs. Be careful with this step especially if you are applying to two specialties or if you are not assigning all letters to all programs.

If I am an IMG, can I have letters sent from doctors in my home country?

You can have letters sent from doctors in your home country, but, unless those doctors have specific connections to residency programs in the United States, they may not be viewed favorably. Letters from U.S. attending physicians, ideally in academic medicine, are the ideal choices.

Sample Letter Of Recommendation

To whom it may concern:

It is with pleasure that I write this letter on behalf of Excellent Student who is applying for residency in surgery. I worked directly with ES for two weeks in March while he was on his core general surgery rotation at the University. During this time, I was an Associate Professor of General Surgery and Clerkship Director for General Surgery. 

ES was always an outstanding student clinically and was well above the expectations of a third year medical student. In our time together, ES cared for numerous patients on the service. Each morning, she would arrive at 5:30 AM, even before the residents and diligently gather information on overnight events, speak with nurses, record laboratory values, and interview patients on her own. Because she was often done with her work before the residents, she then assisted them with any time remaining. During morning rounds, ES always presented her patients in an organized and succinct manner. She paid close attention to details and would often question why his patients had abnormal patterns of laboratory values. She demonstrated an exceptional fund of knowledge that she applied to complex clinical situations. Furthermore, her ability to prioritize problems and create her own plan to address those issues was impressive. ES cared for each of her patients with a rare blend of compassion and sensitivity that is rare for a student her age. She also considered a patient’s family and loved ones when they were present. ES took her role seriously and patients and families often viewed him as “the doctor” rather than a medical student.

In the operating room, I was impressed with ES’s technical skills, ability to know when to step in an assist and when to stay in the background at the ready. Her level of stamina paralleled her curiosity about general surgical techniques. I remember one fairly complex cholecystectomy when the cystic artery was severed and we had to covert to an open procedure. ES expertly assisted during this procedure, staying calm, and the patient did very well. 

Residents on ES’s team remarked at how independent and hard working she was. However, ES also knew when her experience and knowledge limits were met and was not afraid to ask for help. ES was consistently pleasant, personable, easy going and demonstrated great communication skills. Everyone felt that ES was a strong team player, and a professional who would often volunteer to call consults and help with admissions that did not involve her own patients.

Intellectually ES was exceptional. She frequently sought out opportunities to broaden her knowledge base and took an active part in self-directed learning. She read independently on his own patients as well as others and offered to give presentations on various topics. ES presented at our morning conference about cholecystecomy complication and her work was at a resident’s level.

ES consistently impressed me on a daily basis and demonstrated that she is a bright and extremely motivated young woman. I am confident that she will be a tremendous asset to your department and make you proud to have her on your team. I give ES my absolute highest recommendation and consider her to be in the top 5% of students with whom I have worked with in my career. I congratulate the program that is lucky enough to recruit ES. If I can be of any further assistance, please do not hesitate to contact me.

Best regards, The Doctor

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2024-2025 ERAS Residency Application Guide

• By Med School Insiders
• March 26, 2024
• Medical Student
• Residency , Residency Application

The ERAS residency application is completed in your final year of medical school—but really—you should begin preparing yourself for this crucial step throughout your entire time at med school.

Although residencies are educational, they’re quite a bit different from medical school. A residency provides on-the-job training for people to acquire their medical license so that they can become a practicing physician.

This means the application components are quite different from your original medical school application. They must reflect a sense of maturity, growth, and deepened dedication to medicine. Continue reading our ERAS residency application guide, which covers the following topics:

An Introduction to the Electronic Residency Application Service (ERAS)

Eras residency application timeline, what happens next, eras residency application checklist, residency application mistakes to avoid, eras residency application faqs.

The Electronic Residency Application Service (ERAS) is the centralized online application service applicants use to deliver their application and supporting documents to residency programs. ERAS streamlines the application process for applicants as well as their Designated Dean’s Office, letter of recommendation authors, and program directors.

ERAS includes four individual but connected applications, which were created to meet the needs of each user group involved in the application process. ERAS provides an impartial, confidential transmission of all applications to programs.

The 4 ERAS Applications:

• MyERAS is where applicants complete their applications, assign supporting documents, select programs, and submit the materials for their selected programs.
• Dean’s Office Workstation (DWS) is where Designated Dean’s Offices upload medical school transcripts and medical school performance evaluations (MSPEs) in support of the applications submitted through ERAS.
• Letters of Recommendation Portal (LoRP) is where letters of recommendation authors submit their letters in support of the applicant applying through ERAS.
• Program Director’s Workstation (PDWS) is where training programs receive and review applications and supporting documents.

How ERAS Works:

• Applicants receive a token (one-time access code) from their Designated Dean’s Office.
• Applicants use the token to register with MyERAS.
• Applicants complete their MyERAS application, assign supporting documents, select programs, and apply to programs.
• The applicant’s Designated Dean’s Office and letters of recommendation authors upload supporting documents.
• Examining boards receive and process requests for transcripts.
• Programs receive the application materials through the Program Director’s Workstation (PDWS).

Technically speaking, ERAS season begins in June, but you should be thinking about your residency application long before then. Use the earlier part of the year to prepare for application season. In the spring, you should be considering which schools you want to apply to, acquiring letters of recommendation, and thinking about the direction you want to take your personal statement.

The ERAS season begins in early June. Obtain your token (one-time access code) at this time by contacting your Designated Dean’s Office. This will grant you access to MyERAS. It’s also a good idea to determine if you will need to take the Computer-Based Assessment for Sampling Personal Characteristics, also known as Casper.

Here is a list of medical schools that require Casper . If you need to take the test, read our Casper Test Guide for information about scoring, preparation, and more.

Start filling in your application with your work, volunteering, and research experience. Take full advantage of the ERAS Tools and Worksheets for Residency Applicants ; this will help you to determine exactly what kind of information you need to gather to complete your application.

As you work on your application, search for programs you’re interested in and save them for later so that you can organize the correct documents for each program.

June – August

You can only register for ERAS once. Do your utmost to ensure your application is flawless. DO NOT certify your application before you are absolutely sure it is complete, accurate, and exactly what you want to submit. You can only certify your application once—doing so will lock in your application, making it unchangeable for the rest of the application season.

Get all of your details in order and continue fine-tuning your application. Check in to ensure your letters of recommendation are confirmed, get feedback on your personal statement, and make final decisions about which residency programs you want to apply to.

Read: How to Choose a Medical Specialty in 6 Steps

Request your relevant transcripts (USMLE, COMLEX-USA, MSPE, etc.) during this time. You should also begin interview prep during these months so that you are prepared and able to present your best self on the residency interview trail .

ERAS will start accepting applications at the beginning of September. We highly recommend submitting your application well before the deadline . The site also tends to crash around the time they are due because of the high volume of applicants, so ensure you’re not leaving it to the last possible day.

Applications are released to programs at the end of September, and interview invitations can be sent out as early as the next day, so if you submit your application close to the day ERAS releases your application, you could miss out on the first round of interviews.

You also have to apply for the National Resident Matching Program (NRMP) , also known as The Match, around this time, which requires a separate application.

1 | Residency Interviews

Interview season for residency programs begins in October and lasts until February. Don’t stray too far from your computer or phone during this time as ideal interview slots fill up fast. Keep your calendar updated at all times so that you can pick optimal dates as soon as they become available.

Read our Residency Interview Guide , which includes common interview questions, 7 strategies for preparing, what to wear, and resources to guarantee your success.

2 | Matched Through NRMP (National Residency Match Program)

The NRMP, also known as The Match, is a system based on a Nobel Prize-winning algorithm designed to allow medical students who are applying for residency to be placed or “matched” into a residency spot at a US program in their chosen specialty.

To participate in a Match, you need to use the NRMP’s secure Registration, Ranking, and Results (R3) system to register and create a username and password. You must have an AAMC ID to register for the Main Residency Match. After registering with NRMP, log back into ERAS and update your profile with your NRMP ID so that program directors can more easily identify you for placement on the program’s rank order lists.

Learn the 7 Things You Must Know About the NRMP Residency Match .

1 | ERAS Experiences Section

The experience section on the residency application provides an opportunity for you to share your work, volunteering, and research experience. Include all relevant experience—not only the experiences relevant to your specialty. You can tailor your personal statement to your specialty, but when it comes to experiences, you want to highlight all that you’ve been up to and what you’ve learned.

When describing each activity, try to answer these three questions in three sentences: What is it? What did you do? What did you learn? This will help the reader to quickly understand your background and what each activity meant to you. A lot of your interview questions will come from this section, so be sure to review it before any interviews.

2 | ERAS Personal Statement

The residency personal statement is your chance to tell your story, explain why you want to join a certain specialty, and demonstrate why you’re qualified to do so. It’s your single opportunity outside of interviews to personally highlight anything that you feel was underrepresented in other parts of your application and provide necessary context for your accomplishments.

Much of your residency application material focuses on your scores and grades, which don’t tell much about who you are as a person or what you’re passionate about. Your letters of recommendation will shed light on your dedication and professionalism, but the personal statement is your chance to tell your story as you see it.

While this may sound like the medical school personal statement, don’t assume you’ll be able to rehash it when writing your residency personal statement. The two are quite different. Residency programs aren’t looking for medical students; they’re looking for young professionals who have vastly improved their medical knowledge, earned their doctorate, and deepened their focus and dedication to medicine.

Your residency personal statement must reflect these differences. You are no longer a wide-eyed premed. Keep the focus of your personal statement on your professional development and why your experiences have made you want to join a certain specialty. Be confident yet humble about your accomplishments so far, and speak passionately about what you hope to accomplish in the specialty.

Technically, the residency personal statement allows for 28,000 characters. We do not recommend using all of this space. Keep your personal statement to one typed page, which is about 700-800 words.

A stand out essay can be enough to get you an interview offer while a poor statement can shut the door on an otherwise top-tier applicant. View our database of Residency Personal Statement Samples , take careful care editing, ask mentors for feedback, and consider professional personal statement editing .

3 | ERAS Letters of Recommendation

Just like the letters of recommendation for your medical school application, ERAS letters of recommendation give residency programs crucial insight into how professional physicians see you—your work ethic, character, specific strengths and attributes, and how well you’ll fit in and contribute to your chosen specialty.

You are allowed to upload an unlimited number of references, but only a maximum of four letters of recommendation per program. Your MSPE or Dean’s Letter do not count as one of your letters. Your letters do not need to be addressed to the specific residency program but should instead be standardized, so that letter writers do not need to draft multiple letters.

It’s ideal to find writers from a range of different specialties and experiences who you have worked closely with, know you extremely well, and who will speak highly of your skills, work ethic, and personal characteristics. You must have at least one letter from an attending you worked with closely, a department chair, or a mentor in your chosen specialty so that they can speak to your aptitude and suitability for that specific specialty.

Your program may also require a letter from someone outside the field of medicine. Carefully scan the specific program requirements of each program on their website to determine exactly what you’ll need.

4 | ERAS Photo

Adding a photo is optional for your application, but it’s highly recommended, as a friendly, professional photo will help those assessing your application remember you. Faculty will see your photo as they make decisions and deliberate over your potential candidacy for residency, and it will help them identify you when you report to interviews.

Upload your own photo in MyERAS by selecting Upload New Photo in the Actions column.

The photo file cannot exceed these requirements:

• Dimensions: 2.5 in. x 3.5 in.
• Resolution: 150dpi
• File Size: 100kb

Ensure it’s a professional-looking, high-quality photo. Wear professional clothing; ideally, something that would be appropriate for a medical school interview. Smile, and ensure you appear friendly and approachable. The background should be plain and subtle, with nothing that will distract from you.

If you know any photographer friends, this is a good time to ask for a favor. If you aren’t experienced using a professional camera yourself, and you don’t know anyone who is, you should pay for a professional photo. You’ve come all this way and have already spent an unbelievable amount of money on medical school. Pay this small cost to ensure you have a quality headshot.

Learn more: ERAS Residency Application Photo Requirements and Tips .

5 | Transcripts

You need to request your USMLE transcript (or COMLEX-USA transcript for DO schools) for your application. Authorize the release of this document during the summer. As you create a timeline for your final years of medical school, ensure you schedule Step 2CK well before the September of your residency application, as it can take weeks for test results to come back.

If you’ve made the request, your school will assemble your MSPE (Medical School Performance Evaluation) letter and transcripts and upload them for you.

Avoid these common mistakes when preparing for and submitting your residency application.

• Certifying (locking in) your ERAS application before it’s perfect.
• Submitting a bland personal statement that doesn’t directly address why you will be a good fit to join a certain specialty.
• Allowing small mistakes to slip through due to carelessness and sloppy editing.
• Not getting strong letters of recommendation from people who will speak highly of you.
• Rehashing your original medical school personal statement.
• Not bothering to submit a photo of yourself.
• Submitting a low-quality or distracting photo.
• Waiting until the deadline to submit your application.
• Waiting too long to begin researching and considering your preferred specialty.
• Not taking notes during your work, volunteer, and research experiences. (Notes will help you describe your experiences in detail.)
• Not considering your residency application throughout your time in medical school.

Applying to residency is quite a bit different than applying to medical school. Read our 9 essential strategies for applying to residency .

How Do I Access MyERAS?

Contact your Designated Dean’s Office to access MyERAS . They will issue you a token, which is a one-time access code to register for MyERAS.

You must acquire an ERAS token from your own Designated Dean’s Office, as your documents will not be accurately uploaded with a token from a different school or organization. You also must make sure that your ERAS token is from the current MyERAS season, as a token from a previous season will not work. ERAS tokens can only be used once to register.

An AAMC account is required to register for MyERAS. If you don’t already have one, you will need to register for one.

How Much Do Residency Applications Cost?

ERAS application fees are based on the number of programs applied to per specialty. If you apply to up to ten programs, it will cost you $99. If you apply to 11-20 programs, the cost is $19 each. Applying to 21-30 programs will cost you $23 each, and applying to 31 programs or more will cost you $27 each.

Additional fees include your USMLE transcript ($80) or your COMLEX-USA transcript ($80), both of which are assessed once per season.

MyERAS automatically calculates your fees. You can pay online using Visa, MasterCard, American Express, or Discover. ERAS does not offer refunds for any reason.

Are There Programs That Don’t Participate in ERAS?

Some specialties or programs do not participate in ERAS. If that’s the case for a program you are interested in, you need to contact that program directly to determine how to apply.

Which Specialties Require a Supplemental ERAS Application?

There are a few specialties that require a supplemental ERAS application in addition to the main MyERAS application. Internal medicine, dermatology, and general surgery use a short (and free) supplemental ERAS application with new questions that provide programs with more information about applicants.

Residency Application Editing With Med School Insiders

Approaching your residency application with care and tact is critical to your success. Our team of doctors has years of experience helping medical students get matched with their ideal program.

Med School Insiders can help you prepare a stand out residency application. We offer a number of Residency Admissions Consulting Services tailored to your needs, including personal statement editing , USMLE tutoring , interview prep and mock interviews , and overall application editing .

Med School Insiders

10 Residency Application Red Flags (Don’t Make These Mistakes!)

We break down 10 residency application red flags programs watch out for. Don’t make these mistakes!

Do You Get Paid in Residency? How Much Do Resident Doctors Make?

Learn how much resident doctors are paid, the hours they’re expected to work, and whether or not residents feel they’re fairly compensated.

How Long Is Residency? (By Specialty)

We discuss the length of the complete doctor journey and include a chart that shares average residency lengths for the most common specialties.

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Residency Letters of Recommendation Samples

I hope you enjoy reading this blog post.

If you want our team to help you with your Residency Application,  click here .

Letters of Recommendation (LORs) are pivotal in your residency application, providing a unique perspective on your skills, character, and potential from those who know your work best. This blog provides you with sample letters to help you get powerful recommendations that strengthen your residency application.

If you are looking for a full ALL IN ONE Application Resources for MATCH® 2025, including MSPE samples, personal statement examples, ERAS application template, and much more, click here .

We also have detailed guides on LORs , how to write your personal statement , how to complete your ERAS application , and 200+ residency interview questions .

And now, let’s get started with the LOR examples:

Letter of Recommendation Example #1: Internal Medicine

Dear Program Director,

I am writing this letter of recommendation in support of Shiv Roy, who is applying to this year’s match in Internal Medicine. Shiv has been an exceptional student under my mentorship during her US clinical rotations and research endeavors. I have had the privilege of working closely with Shiv during her time at my primary care outpatient clinic in San Diego, where she displayed remarkable dedication, medical knowledge, and a commitment to excellence.

From the outset, Shiv’s depth and breadth of medical knowledge impressed me. During her three-week clerkship at my clinic, she seamlessly integrated herself into the work environment. In a short period, Shiv was actively involved in patient care, performing tasks ranging from taking comprehensive histories and conducting physical examinations to formulating differential diagnoses and implementing treatment plans. I was particularly impressed by her note-taking skills on our electronic medical record system, Epic, which she mastered through her own initiative and meticulousness. Her colleagues and residents also recognized her hard work and exceptional patient care. Outside of this, both the office staff and residents commented on her positive attitude, can-do personality and pleasant nature. Indeed, Shiv’s presence in the office was felt so much that I have even had several patients ask for updates on “Dr. Shiv” since her rotation with us.

Furthermore, Shiv’s enthusiasm extended beyond clinical rotations. Following her time at my clinic, she expressed a desire to engage in research activities within our department. I connected her with Dr. Jim Smith, a respected colleague studying social determinants of developing pulmonary fibrosis. Shiv worked remotely with Dr. Smith for six months, all while completing additional clinical rotations and studying for the three-step sequence of the USMLE. Her commitment to research and her ability to balance multiple responsibilities were truly remarkable.

Throughout her various clinical experiences, Shiv consistently garnered unanimous praise for her hard work, aptitude for learning, and outstanding performance. She possesses a unique combination of intelligence, drive, and leadership qualities that sets her apart from her peers. I have no doubt that she will emerge as a thought leader in her chosen field of specialization and make significant contributions to the medical community.

In addition to her exceptional scholastic achievements, Shiv’s personal qualities further distinguish her. She is an incredibly compassionate individual with strong family values. Shiv’s commitment to supporting her family in India is evident in her willingness to work a second job as a food delivery driver, alongside her full-time responsibilities in the lab. This resilience and empathy demonstrate her determination to overcome challenges and her unwavering dedication to helping others.

Having mentored numerous medical students, residents, fellows, and junior faculty members throughout my career, I can confidently assert that Shiv Roy is a generational talent. Her potential for success is truly outstanding. I hold no reservations in providing my highest recommendation for Shiv as an applicant in this year’s internal medicine match. She is my top choice, and I firmly believe that she will bring great honor to your institution.

Thank you for considering Shiv’s application. Should you require any additional information or have further inquiries, please do not hesitate to contact me. I am more than willing to provide any necessary assistance.

Best Regards, David Smith, M.D., M.S. Associate Professor of Internal Medicine Associate Program Director Department of Internal Medicine University of San Diego

Letter of Recommendation Example #2: Surgery

I am writing this letter in the strongest support of Tom Wambsgans, who has applied for a residency position in General Surgery at your program. Having had the privilege of mentoring Tom for the past four years, I can confidently say that he possesses exceptional qualities and achievements that make him an outstanding candidate in this year’s match.

I first crossed paths with Tom during his initial year of medical school when he reached out to me expressing interest in a research position within our department. From the moment we met, I was immediately captivated by Tom’s charisma, inquisitiveness, and unwavering motivation. During the summer between his first and second years of medical school, Tom joined my lab where he delved into studying the impact of initiating early DVT prophylaxis in postoperative trauma patients. His natural talent for research quickly shone through, and he soon became involved in several other projects within our lab over the subsequent year. Tom’s productivity and dedication were remarkable, leading him to be awarded a highly competitive, funded research fellowship through the Howard Hughes Medical Institute. As a result, he spent a dedicated research year in our lab further exploring his work on venous thromboembolism prophylaxis in acute care/trauma patients, which has resulted in numerous presentations and a manuscript accepted for publication in the Annals of Surgery.

Often, students who take time away from clinical settings struggle to transition back seamlessly. However, Tom defied this trend and hit the ground running. His performance during his Acting Internship was nothing short of stellar. I had the pleasure of working with him for two weeks on the Acute Care Surgery Service, where he quickly assimilated into our large team and became an invaluable asset. Remarkably, Tom’s technical skills surpassed those expected of someone at his level of training, and his medical judgment was consistently sound. Such was the confidence in Tom’s abilities that our consult resident entrusted him with carrying the pager during lighter OR days. The overwhelming support for Tom from the residents who worked alongside him on our service was evident, with many reaching out to me to passionately endorse him and strongly recommend his consideration for our program.

In addition to his time on the Acute Care Surgery Service, Tom also spent two weeks working with our Surgical Oncology service, receiving equally glowing reviews. Our chief resident even went so far as to describe Tom as the strongest acting intern he has encountered throughout his residency. At the conclusion of his month-long rotation, Tom delivered an exceptional presentation to our entire department on the indications for biologic therapy in advanced hepatobiliary cancer. It is worth noting that while Tom has conducted significant research within our department, his decision to immerse himself in an entirely unrelated topic during his rotation demonstrates his admirable ability to step out of his comfort zone—a quality that cannot be taught and is a testament to his exceptional work ethic and adaptability.

Having mentored over 150 medical students and residents during my tenure at the University of Texas, I can confidently assert that Tom ranks among the top 5 individuals in this category. Without a doubt, Tom possesses the qualities, skills, and drive necessary to become a future superstar in the field of surgery. I have no reservations in stating that he will be highly sought after by all elite training programs. It is with the utmost conviction that I provide my highest recommendation for Tom Wambsgans, and I assure you that he will be ranked to match at our program this year.

David Ogmier, M.D., M.B.A. Professor of Surgery University of Texas

Final Thoughts

We hope these examples offer valuable insights into residency letters of recommendation.

If you need help with editing your personal statement or having an expert lay an eye on it and give you comprehensive feedback, don’t hesitate to reach out to us  HERE !

You can also bundle your personal statement editing with ERAS application editing and interview preparation by signing up to our Match Application Packages HERE .

If you have any questions about any of our services, don’t hesitate to reach out to our customer support service here .

Good luck with your application and always remember, The Match Guy is here for you!

To your Match, The Match Guy

The Pathways for ECFMG Certification for MATCH 2025

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General Surgery Residency Personal Statement Examples 

Emergency Medicine Residency Personal Statement Examples 

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ERAS Application 2024 Guide!

How To Write A Good Personal Statement For Your Residency

Medical Student Performance Evaluation for Residency Applicants 

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Applying to Residency Programs

The four main elements of your application to residency are letters of recommendation, the medical school performance evaluation, and your personal statement and curriculum vitae. Providing complete and accurate information about yourself is crucial to connecting with residency programs during the Match process.

Medical students can start building on their CV early in medical school, and begin collecting letters of recommendation before their Match cycle. Taking a long-term, thoughtful approach to your residency application will help set you apart.  

Nearly all Match applicants submit their Match application materials through an online service called the  Electronic Residency Application Service (ERAS) .

NEW: Experts share tips for applications, interviews, ranking and more.  >>  Watch the webinar.  

How do residency programs evaluate match applications.

Match application review committees at residency programs are looking for a variety of qualities when considering which applicants to invite for Match interviews . One way to help ensure you stand out is by making it clear to reviewers why you are specifically interested in training at their program.

Across specialties, each residency program establishes its own system for reviewing applications. Approaches can vary widely. Some programs use filters with specific cut-off criteria, for example, graduation year. Family medicine residencies are leaders in using holistic processes in the Match. Holistic review processes ensure that candidates are evaluated using criteria beyond numerical exam and academic scores. Make sure programs have the whole picture by writing a strong personal statement and securing meaningful letters of recommendation.

Application Elements and Tips

Learn how to write a great CV and personal statement, request meaningful letters of recommendation, and help shape your medical school performance evaluation.

Member Exclusive Video

Applying to residency: from before application to after interview.

Are you ready for the Match? A panel offers strategies and advice for successfully navigating the application, interview, and ranking process. Get answers to some of the biggest questions about the Match.

Not a member? Medical student membership is free and applying is easy. Learn More.

A Note on the Electronic Residency Application System

The Electronic Residency Application Service (ERAS) is an online tool that is provided by the Association of American Medical Colleges (AAMC) and used to automate the residency and fellowship application process. The AAMC provides assistance and instructions on how to access and use ERAS  as an applicant.

ERAS is the system most residency program directors participating in the Main Residency Match use to access information submitted by applicants and medical schools. However, ERAS is not the definitive source for program participation information. You should verify the application process and deadlines for programs in which you’re interested before you apply.

Applicants access ERAS through a token, which is assigned to them through their schools' deans offices. Early access to ERAS will allow you to begin uploading letters of recommendation during third-year clerkships.

Residency Application Requirements for International Medical Graduates

International Medical Graduates (IMGs) must meet certain criteria in order to apply for U.S.-based residency programs.  Learn about IMG requirements »

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A Guide to Medical Residency Letters of Recommendation

• 26 March, 2021
• ERAS Application Letters of Recommendation

Letters of Recommendation (LoRs) have the power to make or break your medical residency application. According to the NRMP® Director Survey, Letters of Recommendation rank #2 among the top 5 most important factors when reviewing a residency candidate’s application.

The strongest Letters of Recommendation are:

• Recent – Within one year of application
• Based on US clinical experience (USCE) – USCE is hands-on work with patients completed in a US medical environment. If you do not have USCE, it’s ok to get LoRs from Observerships or Research experience as long as it’s completed in the US. LoRs from the US prove you have exposure to US medical environments and that you have good communication skills. (See information about foreign LoRs below.)
• Specialty specific – These are LoRs that specifically state your ability in one medical specialty. Ex. “Candidate A would be a great fit for any Family Medicine residency program because…”

Preparing for Letters of Recommendation differs depending on what walk of life you are on. Most residency candidates fit into one of three candidates types:

• Third or Fourth Year Medical Students – Keep an eye out for potential Letter Writers early on in your clinical rotations. Especially consider people who are practitioners within your potential specialty.  BONUS: Asking early means your Letter Writers will be able to get to know you much sooner and more deeply. Make your intentions known right away, and follow up with them every once in awhile to get their feedback.
• Recent Graduates/First Time Applicants – Those of you who are getting their applications ready right now and realizing you need to tackle LoRs, don’t panic! Think carefully about who you’ve worked with over the years. It might even be a good idea to list them and how well they know you. You don’t have to just ask your direct supervisor, ask anyone who you’ve worked with and knows you. When you know who you want to ask, approach them now and start the conversation.
• Older Candidates/Re-Applicants – If you haven’t been in the field for a few years, it is advised you complete some extra US clinical experience time to make sure you have an up-to-date reference for your LoR. You can perform fresh rotations through sub-internships, externships, or observerships as a last resort. Please bear in mind, many programs do not count observerships as US clinical experience (USCE). Anything that counts as USCE that you can draw out LoR from will help you in the long run. If you cannot do more USCE, but you are working in the field, think about asking your supervisors in your current employment.

After you have a clear picture of who you will be asking for Letters of Recommendation, the next step is how to actually ask your Letter Writers for the Letter of Recommendation (if you haven’t already in the past). The main goal is to be polite and grateful and to be sure they have everything they need to write a positive letter.

When it’s time to ask for a Letter of Recommendation try to schedule a one-on-one meeting with them. Bring your CV, resume, or anything else that helps highlight your accomplishments, and make sure to run through these items with them. If you can’t meet face-to-face, arrange a phone call or Skype meeting to talk. A simple email asking them for the letter and attaching documents to read won’t cut it!

Some suggested items to offer your Letter Writer are:

• Letter Request Form from ERAS® application
• Your CV or Resume
• Your Personal Statement (if it’s completed to perfection!)
• Information about your chosen program and school
• Bring their attention to the ACGME Core Competencies
• Anything else that can really bring your accomplishments to light

You may also want to discuss:

• Your chosen specialty (this is how you make a letter specialty specific)
• A deadline, they need to know when they need it to be done by
• Whether or not you want it waived
• Any pointers on format or content if they want to know. Don’t give them a template, but a general direction is always helpful

During your discussion with your Letter Writers, be sure to get their feedback on your performance. Ask them if you have exhibited any qualities strong enough to mention such as enthusiasm, confidence, teamwork, dedication, knowledge, or commitment. If anything comes to their mind, ask or provide them with examples of when you demonstrated these traits.

TIP: If you have an idea of what your Letter Writer is saying about you in the letter, you can integrate what they are saying into your Personal Statement to make both your letter and the Personal Statement stronger. For example, if your Letter Writer says you are an exceptional team player, you can mention your teamwork in the Personal Statement with a story about how well you worked with a team of peers. This adds credibility to both documents.

Once you have talked to your Letter Writer, the Letter of Recommendation will need to be submitted. Submission is different whether or not you waive your right to see your LoRs . If you waive your right to see the letter, this means you will not be able to see the LoR before it is submitted. Not waiving means you can review the letter and submit it yourself.

There are many things to think about when you are deciding whether or not you should waive a LoR.

If you don’t waive :

• You will know exactly what is being submitted
• For example, you may have asked the Head of Surgery for an LoR, but they praised your insight in Internal Medicine, so you should send this letter to Internal Medicine programs, not Surgical programs.
• You can see if the letter is negative, incorrect or generic. You want to make sure the Letter Writer did not just use a template
• As stated before, you can use the content from the letter in your Personal Statement
• If you do have access to your Letters of Recommendation, consider signing up with Residency Experts , where you can receive reviews and feedback on your LoRs (complimentary with most of our packages). You can also submit your Letters of Recommendation for editing, ensuring they are written to absolute perfection before you certify your application.

Bear in mind:

• Not waiving can throw up red flags such as a lack of confidence
• The LoR may seem less genuine and reliable because the reviewers know you looked at it

You will have to think carefully if you want the chance to look at the letter, or if you trust your Letter Writer enough to write you an LoR that will be an asset to your residency application.

If you choose to waive your right to see the Letter of Recommendation, your Letter Writers will need to go to the LoR Portal® (LoRP) on the AAMC® website. Make sure you have researched and understand the submission process before you talk to your Letter Writer.

Before submitting, your Letter Writer will need:

• An AAMC account  
• The Letter Request Form – Each author will need a Letter Request Form specific to the application you want them to write for. Each form has its own ID number. You will need to generate this on your MyERAS Account and provide your Letter Writer with the correct form.
• On a letterhead paper
• Less than 500 KB
• No special characters
• Letter signed by Letter Writer

Remember, ONLY the Letter Writer or someone they designate (the designee) can upload LoRs. The designee cannot be someone from your medical school who is affiliated with the medical residency application process. If you do not waive your right to see the Letter of Recommendation, you may submit the letter yourself.

After you have followed up with your Letter Writers to confirm they have submitted the letter or checked your MyERAS Account, don’t forget to send a Thank You card . A handwritten card is more thoughtful than a simple email.

Letters of Recommendation FAQ:

• I am an IMG. Can I use LoRs from my home country? Technically, yes. Many International Medical Graduates (IMGs) end up needing to use LoRs from their home country. However, LoRs from outside the US hold less weight than LoRs from USCE.
• Can I use someone from another specialty to write about a different specialty? Absolutely! For example, you can ask an Internist to write you a Letter of Recommendation for Psychiatry. Just make sure you tell them about your specialty preference before they write the letter.  
• How many Letters of Recommendation do I need? You may assign a minimum of 3 and a maximum of 4 LoRs (ERAS limit) per program. Most programs want to see the minimum amount of LoRs. You may submit any number of LoRs to your MyERAS account.
• Can I use a specialty specific LoR to apply to another specialty? No! If an LoR is written for one specialty, it is a very bad idea to use it for another specialty. Program Directors like to see passion and dedication for the specialty their program is in, applying with a document for another specialty can be seen as lazy, or even insulting. For example, you would not want to use an Internal Medicine letter to apply to a General Surgery program.

This is just a basic guide to Letters of Recommendation. You can also check out Residency Experts’ helpful tips by reading Your Complete Residency Letter of Recommendation Guide . If you or your Letter Writers have any questions, you can either check out the LoR Portal User Guide on the AAMC website and call 202-862-6264 , or call Match A Resident at 858-221-8510.

Sources and Resources:

• LoR Portal User Guide:  https://www.aamc.org/download/286098/data/lorp_ug.pdf
• ACGME® Core Competencies: http://www.ecfmg.org/echo/acgme-core-competencies.html
• NRMP Director Survey: https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/08/2020-PD-Survey.pdf

 The NATIONAL RESIDENT MATCHING PROGRAM®, The NRMP®, SUPPLEMENTAL OFFER AND ACCEPTANCE PROGRAM®, and SOAP® are registered trademarks of National Resident Matching Program. THE MATCH™ is a trademark of National Resident Matching Program. ResidencyPrep, LLC and this page are not sponsored by, endorsed by, or affiliated with National Resident Matching Program. 

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Creating a high‐quality personal statement for residency application: A guide for medical students and mentors

Adaira landry.

1 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, USA

Wendy C. Coates

2 Department of Emergency Medicine, Harbor‐UCLA Medical Center, University of California, Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles California, USA

Michael Gottlieb

3 Department of Emergency Medicine, Rush University Medical Center, Chicago Illinois, USA

INTRODUCTION

In 2022, a total of 50,830 applicants applied to residency programs in the United States. 1 The majority of the application are data driven, including Step 1 and 2 scores, preclinical and clinical grades, and the Medical Student Performance Evaluation (MSPE or “Dean's Letter”). While there is some flexibility in choosing who writes one's letters of recommendation, there are caps on the number allowed and the contents are usually unknown to the applicant. Therefore, a high‐quality personal statement adds subjectivity and provides flexibility to frame an applicant in the strongest light. Prior research reveals that the personal statement has not always been valued universally. 2 , 3 However, the personal statement may be gaining importance with the recently increased focus on holistic review as well as the transition of USMLE Step 1 to pass/fail and the increasing prevalence of pass/fail grading in U.S. medical schools. 4 , 5 , 6 , 7 This is relevant as objective metrics inconsistently predict a student's ability to practice medicine and succeed in residency 8 , 9 and may present a potential for racial and other forms of bias in applicant selection. 10

While the objective aspects of the application emphasize comparison based on standard measures, the subjective narrative is curated and individualized by the applicant. Moreover, the National Residency Matching Program 2021 Program Director survey data suggest that personal statements influenced some applicants' likelihood of receiving an interview offer, especially when the application was near a program's self‐directed objective cutoff metric; however, its impact on rank list position was less influential. 11 Therefore, it is in the candidate's interest to craft a statement that engages the reviewer. The primary goal of the personal statement must be honest and reflective and be able to tell the story of the applicant (e.g., the influence of their background, key current personal interests, and future goals). Linear and crisp writing makes a personal story easier to read. Despite the stakes, there are few published resources guiding applicants on how to write an effective personal statement. 12

In this paper, we provide recommendations for creating a high‐quality personal statement. The authors have served as advisors to medical students, residents, fellows, and faculty for over 35 years across four separate major academic institutions. They have held core faculty roles, medical school, residency program, or fellowship leadership positions and have served on resident selection and interview committees and in the dean's office. The information compiled here was based on consensus of opinion as well as relevant literature where available. While the primary audience of this article is medical students, the principles may also be valuable for their mentors.

GENERAL GUIDELINES

The personal statement provides context to your personal and professional experiences and ambitions. It should not be a line‐by‐line recap of your entire application. Rather, it should highlight aspects which deserve greater attention and detail than are provided in your curriculum vitae. 13 Resist the urge to exaggerate truth, but do not undersell your accomplishments. Stating what you learned from experiences can strike a balance. The personal statement offers a prime opportunity to discuss gaps in training, motivation to pursue a particular field, notable extracurricular activities, general career plans, and concerns with your application. Controversial topics, such as social or political issues, may occasionally be included after careful consideration on how to frame your message and language. A trusted specialty‐specific advisor or mentor can help determine which key points are strategic to address.

Most importantly, your personal statement should be unique and reflect your personal journey and not be at risk of being mistaken for a different applicant or plagiarized from a published work. We recommend that you craft your personal statement directly from your voice and through your lens. While it is prudent to consult a proofreader to check spelling and grammar, it is unacceptable to hire a writer to construct your statement.

Before writing your personal statement, we recommend engaging in self‐reflection. Focus on the crossroads of your path and application that you want to highlight. These form the central points of your essay and may stimulate conversation during your interview. Your trusted network (mentors, significant others, siblings, parents, and close friends) can help early to identify significant traits and experiences. Anything written in a personal statement is available for discussion during the interview, including some topics that are frequently disallowed. Be prepared to discuss what you disclose. Table  1 summarizes general pearls and pitfalls for the personal statement.

Pearls and pitfalls for the personal statement

WRITING STRATEGICALLY

Writing can be a challenge but following a few basic writing strategies can simplify the task. Creating an outline helps adhere to purposeful clarity and flow. The flow should be linear so that the application reviewer can easily follow the discussion without having to decipher the relevance of content or the meaning of vague analogies. The ability to compose clear, easily readable prose will reflect favorably on your communication skills.

Writing with brevity and paying attention to the word count yields readable, short, and sharp sentences. For many specialties, a one‐page personal statement is the norm; however, ERAS (Electronic Residency Application Service) does have a cap of 28,000 characters (approximately 5 pages). 12 Your mentor can advise on the preferred length for your intended specialty. Use simple words that convey your meaning to enhance comprehension, and avoid overly colorful language and unnecessary adverbs and adjectives. Minimize the temptation to provide extraneous details, especially when trying to set the scene of a clinical environment, patient encounter, or historic event (e.g., a family member with a medical encounter). You should be the focus of your personal statement.

After creating this first draft, several strategies can be used to improve it. Waiting a few days to edit the statement allows you to reread it from a fresh perspective. Trusted allies may offer valuable insights and assess for flow, context, and comprehension. Mentors can evaluate your statement from the lens of a reviewer. Listening to the statement being read aloud can help identify errors. It is common to need several revisions before settling on your ideal personal statement. As a last step, be sure to check the document for spelling and grammar. Table  2 provides resources that will help with the technical craft of writing.

Writing resources

COMPONENTS OF A PERSONAL STATEMENT

There is no rigid template for a personal statement. Its design and development should be sculpted to describe your unique experiences and ambitions, while being mindful of the storytelling and writing principles outlined above. To that end, no singular format or framework will work for every student. The goal is not to capture the reviewer's or programs's exact preferences, because there is too much variability to predict what is desired. 2 The primary goal of the personal statement is to write clearly about your journey so that reviewers understand who you are. In this section, we provide examples of components to consider including in your personal statement. We do not expect that each of these components will be included in everyone's personal statement. Instead, each author should decide which components best represent their desired message. We understand the temptation to be creative with your writing; however, we recommend caution. A lively statement, specifically in the opening, runs the risk of being cliché or distracting. Table  3 offers suggestions of how to structure the description of your experiences.

Approach to describing experiences in personal statement

Motivation for pursuing medicine overall (consider including, if desired)

The decision to pursue the field of medicine is significant and worthy of discussion. Often students open with a brief description of an educational or clinical encounter, a relative's journey as a patient, or even a personal illness. You may briefly state your reasons for becoming a physician (e.g., enjoyment of clinical medicine, desire to improve health care delivery). No matter the influence that inspired you to pursue medicine, reviewers will appreciate your authenticity.

Motivation for selected residency field (included by many applicants 14 , 15 )

Describe why you are applying to your specialty and highlight personal traits and experiences that make you an ideal fit. Mentors in your desired specialty can discuss the strengths, weaknesses, and future of the field and can assess your compatibility. Avoid superficial phrasing such as “I am applying to emergency medicine because I am interested in helping people.” While this answer is honorable, it lacks a detailed understanding of the nuanced aspects of the field and could apply to any student and specialty. There is no need to describe the specialty to the readers—they are living it daily and want to learn why you will succeed within the specialty's framework.

Tentative plans for residency and career (included by strongest applicants)

If you have tentative plans for residency, possible fellowship, and your subsequent career path, you can include them and any supporting evidence. For instance, “Based on my research thesis studying cardiac biomarkers, I plan to focus on early signs of cardiac disease. I will pursue a fellowship in population health, obtain a Master of Public Health degree, and later work in an academic setting.” You may also link these ambitions, whether clinical or nonclinical, back to why you pursued medicine or the specific discipline. Selection committees value your ability to create a global plan, but they also understand that it may change during residency and will not be disappointed if you revise your path as you discover new opportunities during your training.

Brief context of academic experiences (consider including, if applicable)

The variety of applicants' experiences is as varied as the applicants themselves. It is important to clarify your motivation for engaging in an activity, the depth of your role, and how you improved as a result of your participation. For example, the experiences of a student who is listed as an author on a publication may vary from data entry to principal investigator. An honest reflection of your role and lessons learned is far better than hyperbole. Describe your decision making behind a project and how your skills improved or how it influenced your personal mission as a result. Detailed descriptions are not necessary. Instead, focus on the key components of one or two influential experiences. You may be expected to elucidate the details during your interview.

Relevance of extracurricular activities and prior employment (consider including, if applicable)

Most applicants have a long list of activities to report, and many may not be well understood by the selections committee. The personal statement gives you an opportunity to frame selected experiences. Highlight your important role in an activity or why the activity endorses your potential success in your specialty. There is a significant distinction between a student who created a student‐run clinic (e.g., generated the idea, sought approval, built a team, gathered supplies, scheduled students and faculty) and a student who staffed the clinic twice during medical school. Similarly, your role in a previous job, whether it was career focused or casual, can shed light on your skills (e.g., to highlight management skills, you could recount your experience as a residence hall assistant in college or your role as a team leader in industry).

Special considerations (consider including, if applicable)

The following are selected special considerations for writing your personal statement. They can carry a higher level of sensitivity, so be mindful of word choice. We want to emphasize the importance of discussing your approach with a trusted advisor or mentor. Be prepared to discuss any topics mentioned in the statement during your interview. While this may seem daunting at first, it is an opportunity to directly answer a question that the selection committee may have while reviewing your application. Reading your thoughtful explanation may allay their fears about the event in question and spur their decision to take a chance on extending an interview invitation. No matter the issue, be sure to demonstrate personal and professional growth and how, if at all, the concern enhanced your ability to become a physician.

Leave of absence

If you took a formal leave from medical school, we suggest you acknowledge it in your application. While ERAS has a designated section for leave of absences, consider also mentioning the absence in the broader context of the personal statement. You are not obligated to provide details. You are free to state, “I took 3 months off for a familial obligation.” However, further details can help the reviewer contextualize the absence: “This allowed me to spend the necessary time addressing the issue without compromising my training. Upon my return from leave, I fulfilled the expectations of my medical school.” It is important that your reason for the leave of absence is viewed by the school in the same fashion. If there is any conflict in the purpose of the leave, speak with your medical school leadership to discuss and resolve any disconnect.

Medical history

You are not mandated to disclose medical conditions. However, if the condition precludes you from performing your duties completely or partially, it is in your best interest to assess whether the program is supportive of providing the least restrictive accommodations for you to participate fully in the training program. While the Americans with Disabilities Act and Rehabilitation Act requires employers to provide reasonable accommodations, it does not require that you disclose your disability until they are needed. Early disclosure gives employers ample lead time to put accommodations into place but may also lead to bias. 16 , 17 We recommend you discuss with your support system when and whether to disclose a disability and whether this decision will cause relief or worry for you and your potential employer.

Shelf exam/board scores/grades

Standardized test scores may influence students' interview opportunities and ability to match in residency. 11 It is prudent to discuss low scores or failures. A brief but clear description of the likely cause, remediation process, and subsequent successful outcome is needed. Any additional positive data points can be mentioned. For example, “I have since passed all of my shelf exams and my Step 2 score was in the Xth percentile.”

Concerning evaluation

Clerkship evaluations on the MSPE may contain negative comments that might be detrimental to the application. You are generally allowed to review your MSPE prior to finalization. If a detrimental comment is found, you should discuss evaluation concerns with your mentor as soon as possible to plan how to mitigate any negativity. Some negative comments are truthful and constructive and will remain in the MSPE. If the comment remains in the MSPE, the personal statement is available to explain the circumstances clearly and concisely and without casting blame on others. It is important to share the most important stage of processing feedback: self‐reflection and identifying areas of growth. 18 , 19 It is reasonable to direct the reader to subsequent instances of how the initial concern later was cited as a strength.

Limited access to extracurricular activities

Statements often highlight select activities so the reviewer can focus on what you perceive to be the most influential activities. However, not all students have access to the same experiences. There is no clear quantitative marker for how many extracurricular activities such as research, volunteering, or leadership roles one should obtain. Resources can vary from one institution to another, and individuals may not have time to engage in copious activities if they have other financial or family obligations during medical school. The personal statement is an opportunity to briefly explain any limitations with obtaining extracurricular activities.

Social and political factors

Often our personal identity is closely entwined with our societal and political experiences. It is an individual choice how to tell your perspective through your personal lens and whether to disclose your preferences. Incorporating personal identifiers, such as your gender, race, age, ability, sexual orientation, parenting status, religion, or political affiliation, informs the reader on aspects of your life that you feel have influenced your journey. 6 , 7 Revealing these can run the risk of unfair or discriminatory judgment but can also demonstrate your comfort with yourself and positively support the reasons you will shine as a resident physician. 12 Depending on your passion and involvement in a particular topic, this can be an opportune segue to explain your interest and future ambitions. Be prepared to discuss any of these disclosures during your interview. Consulting with your mentor is a good way to gauge the impact this decision may have on your application.

Writing a personal statement can be a challenging task. A thoughtful, organized approach will help you create a meaningful personal statement that enhances your application. Streamline the writing to convey your message concisely. The best personal statements are clear and brief and contain specificity to reflect and explain your unique perspective. This is your opportunity to highlight why you are the ideal candidate for a residency in your chosen field. While this guide cannot guarantee an interview invitation or a match into a desired program, we hope this resource will help ensure that your personal statements can showcase your best possible self.

CONFLICT OF INTEREST

AL has received funding personally from EchoNous for consulting. The other authors declare no potential conflicts of interest.

ACKNOWLEDGMENT

The authors acknowledge Drs. Michelle Lin at UCSF and Sara Krzyzaniak at Stanford for their advice on leave of absences.

Landry A, Coates WC, Gottlieb M. Creating a high‐quality personal statement for residency application: A guide for medical students and mentors . AEM Educ Train . 2022; 6 :e10797. doi: 10.1002/aet2.10797 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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Application Process

All applications should be submitted using the Electronic Residency Application Service (ERAS) . The Neurology residency program matches via the National Residency Matching Program (NRMP) .

Following ACGME and NRMP reccomendations, we will conduct all residency recruitment actitivites virtually. While we accept international and foreign medical graduates and will sponsor J-1 visas, we do not sponsor H1 or 01 visas for program applicants. 

Applicant Qualifactions:

• Applicants must be eligible to graduate from an approved American or Canadian medical or Osteopathic school or hold permanent certification by the Educational Council for Foreign Medical Graduates (ECFMG).
• Applicants must be eligible for a Texas Physician-in-Training Permit (PIT).
• Applications will be considered, and interviews offered prior to receiving Step 2 scores, however, successful completion of Step 2 (USMLE or COMLEX) is required before the rank list is submitted.

Your ERAS application should include the following documents:

• MSPE or Dean's letter from your medical school
• Medical school transcripts
• USMLE or COMLEX transcripts for parts 1 and 2
• ECFMG certificate (IMG only)
• Three letters of recommendation

Dates to Remember:

Interviews and hiring process:

The Adult Neurology Residency Program accepts four candidates each year. The program is currently an advanced one and will accept residents starting in the PGY-2 year. However, in 2025-2026 season, we will interview candidates for both PGY-1 and PGY-2 years with a PGY1 start date of July 2026. An applicant who matches into Neurology, will automatically match in the transitional year for internship. The goal is eventually to become a categorical program in Neurology.

Interview and Matching Process:

Neurology interviews will take place on Thursday afternoons and Friday mornings. All applications will be reviewed fairly on their individual merit, and we do not place exclusions based on USMLE/COMLEX scores, publications, number of years since medical school graduation and research experience. US clinical experience is a plus but not mandatory. Applications will receive invitations for interviews via email.

Non-U.S. applicants (IMG)

There are no specific requirements for IMGs/FMGs; invitations for interviews are made based on a combination of USMLE scores, personal statement, recommendation letters, clinical experience, and other factors.

• All applications should be sent through ERAS.
• The program will sponsor J-1 visas (H-1B visas will not be supported).
• US clinical experience is preferred.
• Proficiency in typing and English language is preferred.
• IMG candidates must have passed USMLE Step 1 and 2 and hold a permanent ECFMG certificate.

Once you have matched in our residency program, you will be contacted by the residency coordinator to start the process of onboarding. It may entail completion of forms, verification of visa status, completion of application for the Physician in Training permit (PIT), amongst other things. Permanent Texas state medical licensure is a plus but not mandatory.

Orientation

The Office of Graduate Medical Education in the School of Medicine will have an institutional orientation program; details will be provided once you have matched. The department of Neurology will have its own orientation program on another date to avoid conflict.

Virtual Application Packet

Educational*

• Laptop computer during residency
• Pub Med and Up-To-Date provided by HSC
• Registration paid for applicable certification courses (ex. ACLS)
• Funds available up to $500 toward Step 3 or COMLEX 3 exam
• Funds available up to $700 toward Texas Medical License
• Funds available up to $500 per academic year for books and other approved educational resources

* May not apply to all programs. Please clarify with program coordinator.

Miscellaneous*

• Pension/profit sharing plan
• Free resident parking at most hospitals
• Complimentary access to workout facility
• Personalized lab coats and/or scrubs

*May not apply to all programs. Please clarify with program coordinator.

Moonlighting

• For the initial 1-2 years, to allow time for the new program to be established, we will not approve moonlighting hours.
• With program director approval, future moonlighting opportunities may be available to residents who have obtained a Texas Medical Board license.